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Trial registered on ANZCTR
Registration number
ACTRN12609000974202
Ethics application status
Approved
Date submitted
16/06/2009
Date registered
11/11/2009
Date last updated
30/08/2024
Date data sharing statement initially provided
30/08/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
Lung recruitment maneuvers for acute lung collapse in ventilated patients.
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Scientific title
The efficacy of lung recruitment manoeuvres versus standard care in resolving acute lung collapse on chest x-ray in ventilated patients.
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute lung collapse
236906
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Condition category
Condition code
Respiratory
237260
237260
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0
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Asthma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients in the treatment group will be positioned in side lying with the affected side uppermost and ventilated in pressure controlled mode with a pressure control level of 15 cmH2O (up to 18) and will receive a step-wise recruitment treatment protocol where positive end expiratory pressure (PEEP) is increased incrementally from 10 (or other baseline) to 20, 30cm H20 every 2 minutes and then decreased to PEEP of 15cmH2O. This will be maintained for the remainder of the day with one short re-recruitment maneuver (to max pressure 40cmH2O for 2 minutes). 4 hours prior to reassessment the patient will be returned to pre-existing ventilatory settings and previous PEEP levels. Patients will receive an staircase recruitment manoeuver (SRM) every day for the duration of mechanical ventilation.
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Intervention code [1]
236695
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Treatment: Other
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Comparator / control treatment
Standard treatment (patient will be positioned side lying with the collapsed lung uppermost. Physiotherapists will apply ventilator hyperinlfation which is large tidal volume breaths with peak inspiratory pressure < 40cmH20 for 10 minutes).
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Control group
Active
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Outcomes
Primary outcome [1]
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Chest-x-ray score
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Assessment method [1]
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Timepoint [1]
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24 hours following randomisation
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Primary outcome [2]
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partial pressure of oxygen in the blood as measured by blood gas analysis divided by the fraction of inspired oxygen (PaO2/FiO2)
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Assessment method [2]
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Timepoint [2]
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24 hours following randomisation
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Primary outcome [3]
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Static lung compliance measured by automatic flow interruption technique
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Assessment method [3]
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Timepoint [3]
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24 hours following randomisation
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Secondary outcome [1]
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Ventilator associated pneumonia diagnosed using assessment of symptoms, x-ray and sputum analysis
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Assessment method [1]
242266
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Timepoint [1]
242266
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During intubation assessed daily
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Eligibility
Key inclusion criteria
Patients will be eligible for inclusion is they are mechanically ventilated, have an arterial line for blood gas analyses and blood pressure monitoring, a central venous catheter and are diagnosed with chest x-ray collapse/atelectasis on the morning of data collection by the intensive care unit (ICU) consultant or senior registrar on call. No new lines will be placed for study inclusion.
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Minimum age
16
Years
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Maximum age
90
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients will be excluded if they have an ICC (intercostals catheter) in situ with current or previous air leak, a pneumothorax on chest x-ray, acute respiratory distress syndrome (ARDS) , acute bronchospasm, raised intracranial pressure, acute pulmonary oedema or haemodynamic instability (mean arterial pressure<60 mmHg, arrhythmias).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Screened daily by research nurses for acute lung collapse if ventilated.
If fits inclusion criteria and not exclusion criteria patient will be allocated randomly by computer generated sequence by blinded person to study and sealed in opaque envelope.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated sequence by blinded person to study.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2009
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Actual
15/07/2009
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Date of last participant enrolment
Anticipated
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Actual
18/01/2010
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Date of last data collection
Anticipated
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Actual
18/01/2010
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Sample size
Target
52
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Accrual to date
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Final
40
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Alfred Hospital
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Address [1]
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Commercial Rd Prahran
VICTORIA 3181
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Alfred Hospital
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Address
Commercial Rd Prahran
VICTORIA 3181
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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Monash
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Address [1]
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Peninsula Campus PO Box 527 Frankston, Victoria, 3199
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Alfred Hospital
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Ethics committee address [1]
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Commercial Rd Prahran VICTORIA 3181
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
239257
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15/06/2009
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Approval date [1]
239257
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14/07/2009
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Ethics approval number [1]
239257
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1/09/0176
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Summary
Brief summary
To determine if recruitment manoeuvres are more effective than standard care in resolving acute lung collapse on chest x-ray.
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Trial website
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Trial related presentations / publications
This trial has not been published
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Carol Hodgson
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Address
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Physiotherapy Department
Alfred Hospital
Commercial Rd Prahran
VICTORIA 3181
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Country
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Australia
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Phone
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61 3 9076 3452
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Fax
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61 3 9076 2702
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Email
12933
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[email protected]
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Contact person for scientific queries
Name
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Carol Hodgson
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Address
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Physiotheapy Department
Alfred Hospital
Commercial Rd Prahran
VICTORIA 3181
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Country
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Australia
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Phone
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61 3 9076 3452
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Fax
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61 3 9076 2702
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Email
3861
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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